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Actinate Keratosis

July 2013

You have probably never heard of it, yet millions suffer from Actinate Keratosis (AK)

Most of us will never have heard of this. But when you learn that the current estimate of people in America who are suffering from actinate keratosis (or AK) is around 58 million the problem suddenly grabs your attention. The National Institute for Health and Clinical Excellence (NICE) in the UK estimates that nearly a quarter of people in the UK aged over 60 have AK.

So what is it? Actinate Keratosis is the name for dry scaly patches of skin, they can be minimal or look quite ugly and they can also be itchy. They are of particular interest to us because they generally affect people over the age of 40. Importantly, while most turn out to be harmless, some can progress to squamous cell carcinoma (a less dangerous type than some cancers, but nevertheless a cancer that can spread).

The term AK was only coined in 1958 and actually means thickened scaly growth (keratosis) caused by sunlight (actinic). The problem can also be called solar keratosis. As its name suggests, it usually arises after years of over exposure to the sun. In Australia it is estimated that over 50% of the population aged over 40 is affected.

The patches can turn pink, red or brown and be tiny up to 3 cms across. They can sometimes become thick. They are most commonly found on the face, neck, forearms, the backs of hands and for women, on legs below the knees. For men, another common area is on the rims of the ears. Men are actually more affected than women, perhaps because higher numbers work outside.

If you have an unusual patch of skin, it is worth popping to the doctor. A GP should be able to diagnose AK simply by its appearance, but occasionally a skin sample needs to be taken to confirm the diagnosis.

Treatment can be simple. Sometimes a cream or gel such as Aldara or Efudix is prescribed to be applied daily for several weeks. This causes the abnormal skin cells causing the AK to die. There can be some side effects, for instance the skin can become sore and sometimes even weep and blister, but this should disappear once the treatment stops.

If there is concern that the patch may be cancerous or on the way to progressing into a skin cancer, it may be cut out under a local anaesthetic. This can leave a permanent scar.

Other treatments include cryotherapy, when the patch is frozen, and photodynamic therapy involving a cream with an ingredient that is activated under blue light. Picato gel is a new treatment involves the use of sap from a common garden weed that is said to be fast acting and very effective.

Once the treatment has been completed the AK should go away, but it is important to be aware that developing AK indicates sun damage to your skin, and you may well develop other patches over time.

Skin damage cannot be reversed, so it is important to ensure full protection from further sun damage.

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